Benign recurrent intrahepatic cholestasis type 2 in siblings with novel ABCB11 gene mutations

Benign recurrent intrahepatic cholestasis type 2 in siblings with novel ABCB11 gene mutations

Benign recurrent intrahepatic cholestasis type 2 in siblings with novel ABCB11 gene mutations

(포스터):
Release Date : 2017. 10. 26(목)
Min Ji Sohn1, Min Hyung Woo1, Moon Woo Seong2, Sung Sup Park2, Gyeong Hoon Kang3, Jin Soo Moon1,4 , Jae Sung Ko1,4
Seoul National Univesity Children's Hospital Department of Pediatrics1
Seoul National Univesity College of Medicine Department of Laboratory Medicine2
Seoul National Univesity College of Medicine Department of Pathology3
Seoul National Univesity College of Medicine Department of Pediatrics4
손민지1, 우민형1, 성문우2, 박성섭2, 강경훈3, 문진수1,4 , 고재성1,4
서울대학교 어린이병원 소아청소년과1
서울대학교 의과대학 진단검사의학과2
서울대학교 의과대학 병리학과3
서울대학교 의과대학 소아청소년과4

Abstract

Benign recurrent intrahepatic cholestasis (BRIC) is a rare cause of cholestasis in children, characterized by recurrent episodes of cholestasis without permanent liver damage. BRIC type 2 is an autosomal recessively inherited disorder caused by mutations in ABCB11 gene. A 6-year-old girl had recurrent episodes of jaundice and pruritus. At 2 months of her age, she had jaundice with hepatosplenomegaly. Liver function tests showed cholestatic hepatitis and low GGT level. Liver biopsy revealed diffuse giant cell transformation, ballooning degeneration, bile duct paucity, intracytoplasmic cholestasis, moderate portal inflammation, and periportal fibrosis. ABCB11 gene study revealed novel compound heterozygous mutations including c.2075+3A>G in IVS17, and p.R1221K. Her liver function test was normalized at 12 months of age. At the age of 5 years, she developed abdominal pain, steatorrhea, jaundice and pruritus. Her liver function tests and pruritus improved after starting phenylbutyrate and rifampicin. The BRIC type 2 was diagnosed because of recurrent cholestasis and ABCB11 gene study. Her younger brother had jaundice at 2 months of age and his genetic test revealed the same mutations as his sister. This is the first report of BRIC 2 confirmed by ABCB11 gene study in Korea.

Keywords: Benign recurrent intrahepatic cholestasis, ABCB11, BRIC 2